The Creation and Evolution of the Smarter Lunchrooms Scorecard

Transcription

1 The Creation and Evolution of the Smarter Lunchrooms Scorecard Presented by David Just, PhD, Professor and Co-director of the Center for Behavioral Economics in Child Nutrition Programs at Cornell University Welcome, thank you for joining! During the last 10 minutes of this presentation David will address as many questions as time allows. To ask a question please use the Q & A feature. If you are interested in joining the Healthy Food Choices in Schools Community of Practice or have any questions, please contact us at: healthy_food_choices_in_schools@cornell.edu

2 NUDGING CHILDREN TO EAT HEALTHIER Smarter Lunchrooms Movement, Cornell University 2017 Funded in part by USDA FNS/ERS

3 The Creation and Evolution of the Smarter Lunchrooms Scorecard David R. Just

4 The Early Motivation Low cost use of behavioral principles to encourage better eating A collection of behavioral research results Smarter Lunchrooms Vision Began to receive requests to diagnose schools across the country A simple tool to allow those with little background to implement on their own

5 The Matrix (2012)

6 The Process 1. Establishing general principles based upon accepted behavioral science What influences food choice in the moment? Visual/physical cues of portion size norms Convenience Visibility Taste Expectations Suggestive selling Bundling

7 The Process 2. What strategies are supported by the research literature?

8 The Process 3. How can these strategies be operationalized for likely school goals? Increasing vegetable selection Increasing white milk selection Decreasing waste Increasing participation

9 Established Behavioral Science Ebbinghaus (later Tichtener) Delboeuf- 1887

10 Work Specific to School Lunchrooms In prioritizing strategies, we focused first on work established in school lunchrooms Demonstrates some practical ability to apply in the right context Provides the best evidence of actual effect Stress on strategies we can find multiple support for

11 Other Work in Food Environments If no work had been done in the lunchroom Is there work in other context or labs with children If not children is there work on older populations These points rely on generalizability Are they based upon well known phenomena that are likely to prevail in a school setting? Can we really implement this in a school lunchroom?

12 Example 1: At least 2 kinds of fruit are offered Behavioral principal: Kelley, Harold H. "Attribution theory in social psychology." Nebraska symposium on motivation. University of Nebraska Press, The individual wants to know the causal structure of the environment Interpret selection as being a result of rational intent Langer, Ellen J. "Rethinking the role of thought in social interaction." New directions in attribution research 2 (1978): We are compelled to find a rationale for our actions Can influence future decisions

13 Example 1: At least 2 kinds of fruit are offered Lab work: Carrots vs. Celery simple test of whether choosing between carrots and celery versus passively taking carrots impacts consumption decisions Field work: Roe, L. S., Meengs, J. S., Birch, L. L., & Rolls, B. J. (2013). Serving a variety of vegetables and fruit as a snack increased intake in preschool children. The American journal of clinical nutrition, 98(3), Children offered snacks with a variety of fruits and vegetables selected more often (94$ vs. 70%) and consumed more (about 31g) Hakim, S. M. and G. Meissen. (2013) Increasing Consumption of Fruits and Vegetables in the School Cafeteria: The Influence of Active Choice. Journal of Health Care for the Poor and Underserved, 24(2): Replication of Carrots vs. Celery There was a 15% increase in consumption on days when students made an active choice 10 days pre, 10 days post

14 Example 2: Fruit is offered in at least 2 locations Behavioral principal: Tulving, Endel, and Daniel L. Schacter. "Priming and human memory systems." Science (1990): 301. Viewing objects or words changes the way we respond to closely related objects in the near term Related objects are activated in memory, changing how quickly we recognized them Lab work Strahan, Erin J., Steven J. Spencer, and Mark P. Zanna. "Subliminal priming and persuasion: Striking while the iron is hot." Journal of Experimental Social Psychology 38.6 (2002): College students shown words relating to thirst reported being more thirsty and were more likely to have a drink

15 Example 2: Fruit is offered in Field work at least 2 locations Harris, Jennifer L., John A. Bargh, and Kelly D. Brownell. "Priming effects of television food advertising on eating behavior." Health psychology 28.4 (2009): 404. An experiment with elementary school aged children Children ate 45% more when exposed to food on TV versus non-food Perry, C.L., Bishop, D., Taylor, G.L., Davis, M., Story, M., Gray, C., Bishop, S.C., Warren Mays, R.A., Lytle, L.A. & Harnack, L. (2004) A randomized school trial of environmental strategies to encourage fruit and vegetable consumption among children. Health Educ. Behav. 31, More fruit and vegetables on the school lunch line increases consumption Lytle, L. A., Kubik, M. Y., Perry, C., Story, M., Birnbaum, A. S., & Murray, D. M. (2006). Influencing healthful food choices in school and home environments: results from the TEENS study. Preventive medicine, 43(1), Offering more fruit and vegetables in a la carte lines as well as regular lines increases fruit and vegetable sales (primarily in a la carte) Cardenas, M. K., Bensiger, C. P., Pillay, T. D. and J.J. Miranda. (2014) The effect of changes in visibility and price on fruit purchasing at a university cafeteria in Lima, Peru. Journal of Public Health Nutrition: 1-8. Experiment, introducing an additional instance of fruit displayed near the register with a price reduction Fruit purchases doubled

16 Example 3: Lunchroom is branded and decorated in a way that reflects the student body Behavioral principal Chaudhuri, Arjun, and Morris B. Holbrook. "The chain of effects from brand trust and brand affect to brand performance: the role of brand loyalty." Journal of marketing 65.2 (2001): Branding influences purchases and loyalty Large scale survey (one of many such studies) Lab work PJ Horne, K Tapper, CF Lowe, CA Hardman, MC Jackson and J Woolner. (2004) "Increasing children's fruit and vegetable consumption: a peermodeling and reward-based intervention." European Journal of Clinical Nutrition, 58: Cartoon characters eating fruits and vegetables increased consumption on 16 days

17 Example 3: Lunchroom is branded and decorated in a way that reflects the student body Field work Hanks, Andrew S., David R. Just, and Adam Brumberg. "Marketing vegetables in elementary school cafeterias to increase uptake." Pediatrics (2016): e Vegetable characters on salad bar wrap increased selection of salad Killeen, J. P., Evans, G. W., & Danko, S. (2003). The role of permanent student artwork in students sense of ownership in an elementary school. Environment and Behavior, 35(2), They find generally positive behavioral impacts of allowing students to display artwork Maxwell, L. E., & Chmielewski, E. J. (2008). Environmental personalization and elementary school children's self-esteem. Journal of Environmental Psychology, 28(2), Personalization of the school lunchroom space can positively effect self esteem

18 The Product

19 Testing and Rollout Used groups of novices Several would visit each school All filled out a scorecard Reliability rated above 90% Helped anyone diagnose and prescribe Became part of all trainings in 2014 Parts incorporated in HUSSC Started to survey schools on their use of the 100 strategies in 2015

20 Feedback and Revision Since its introduction we have trained thousands with the 100 point scorecard Last year we undertook a revision Very long Simpler Some wording was ambiguous Shorter Not everything applies to every school Easier to use Not everything varied between schools Somewhat repetitive

21 The New 60 Point Scorecard

22 The New 60 Point Scorecard The same research proven strategies Pre-tested wording and applicability with school lunch staff and managers Similar reliability ratings Similar award levels despite score changes Now incorporated in our national surveys Future plans for further effectiveness training as it comes into wider use